ArticleCurrent oncology (Toronto, Ont.)2020
Association between waiting time for radiotherapy after surgery for early-stage breast cancer and survival outcomes in Ontario: a population-based outcomes study.
Article in Current oncology (Toronto, Ont.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 17 citations in OpenAlex.
- Premastectomy Radiotherapy and Immediate Breast Reconstruction: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Referral delays in metastatic breast cancer care: barriers and facilitators across a fragmented pathway.BMJ open quality · 2026Article
- Improving Access to Radiotherapy Services in Gauteng: Quantitative Analysis of Key Time Intervals from Diagnosis to Treatment.International journal of environmental research and public health · 2025Article
- A data-driven approach to solve the RT scheduling problem.Technical innovations & patient support in radiation oncology · 2024Article
- Temporal Sequencing of Multimodal Treatment in Immediate Breast Reconstruction and Implications for Wait Times: A Regional Canadian Cross-Sectional Study.Plastic surgery (Oakville, Ont.) · 2024Article
- Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review of the Adjuvant Combinations Journey.Journal of clinical medicine · 2024Review
- Breast Cancer Adjuvant Radiotherapy in Up-Front to Chemotherapy: Is There a Worthwhile Benefit? A Preliminary Report.Breast cancer (Dove Medical Press) · 2024Article
- Delays in Initiating Anti-Cancer Therapy for Early-Stage Breast Cancer-How Slow Can We Go?Journal of clinical medicine · 2023Review
- Primary radiotherapy and deep inferior epigastric perforator flap reconstruction for patients with breast cancer (PRADA): a multicentre, prospective, non-randomised, feasibility study.The Lancet. Oncology · 2022Article
- Coronavirus disease 2019 and radiation oncology-survey on the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on health care professionals in radiation oncology.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Article
- Assessment of Breast Cancer Management in Sub-Saharan Africa.JCO global oncology · 2021Article
- GENERATOR Breast DataMart-The Novel Breast Cancer Data Discovery System for Research and Monitoring: Preliminary Results and Future Perspectives.Journal of personalized medicine · 2021Article
- Large Tumor Size is an Indicator for the Timely Administration of Adjuvant Radiotherapy in Luminal Breast Cancer with Positive Lymph Node.Cancer management and research · 2021Article
- Up-front Hypofractionated Radiotherapy Before Third-Generation Chemotherapy in Node-positive Breast Cancer: A Retrospective Comparative Study.In vivo (Athens, Greece)Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: After surgery for early-stage breast cancer (bca), adjuvant radiotherapy (rt) decreases the risk of locoregional recurrence and death from bca. It is unclear whether delays to the initiation of adjuvant rt are associated with inferior survival outcomes. Methods: This population-based retrospective cohort study included a random sample of 25% of all women with stage i or ii bca treated with adjuvant rt in Ontario between 1 September 2001 and 31 August 2002, when, because of capacity issues, wait times for radiation were abnormally long. Pathology reports were manually abstracted and deterministically linked to population-level administrative databases to obtain information about recurrence and survival outcomes. Cox proportional hazards modelling was used to evaluate the association between waiting time and survival outcomes. A composite survival outcome was used to ensure that all possible measurable harms of delay would be captured. The composite outcome, event-free survival, included locoregional recurrence, development of metastatic disease, and bca-specific mortality. Results: We identified 1028 women with stage i or ii bca who were treated with breast-conserving surgery and adjuvant rt. For the 599 women who were treated with adjuvant radiation without intervening chemotherapy, a waiting time of 12 weeks or more from surgery to the start of radiation appeared to be associated with worse event-free survival after a median follow-up of 7.2 years (hazard ratio for the composite outcome: 1.44; 95% confidence interval: 0.98 to 2.11; Conclusions: Delay to the initiation of adjuvant rt after breast-conserving surgery is associated with inferior bca survival outcomes. The good prognosis for patients with early-stage bca limits the statistical power to detect an effect of delay to rt. Given that there is no plausible advantage to delay, we agree with Mackillop that time to initiation of rt should be kept "as short as reasonably achievable."
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